J Am Pharm Assoc (2003). 2020 Jan-Feb;60(1):248-252. doi: 10.1016/j.japh.2019.09.023. Epub 2019 Nov 22.
To report a case of accidental cannabidiol (CBD) oil overdose in a pediatric patient.
CBD is one of over 100 pharmacologically active compounds in the marijuana plant (Cannabis sativa). Its absence of psychoactive effects and the abundance of anecdotal claims of effectiveness across a wide variety of conditions in both mainstream and social media have created an incredible amount of public interest in CBD oil in recent years. Such interest has led to increased consumer availability. Despite this increased access, such sales remain illegal at the federal level. While sales of CBD products not approved by the Food and Drug Administration continue to rise, purity, potency, labeling, and delivery devices remain inconsistent. This may lead to an increased risk of adverse events. The following report describes a case of accidental CBD overdose in a pediatric patient leading to a stay in the pediatric intensive care unit.
The patient initially presented to the urgent care and was quickly transferred to the emergency department after being found unresponsive after administration of a dose of CBD oil earlier in the day. After arrival, his mental status and respiratory drive continued to deteriorate, and he was ultimately intubated. He was eventually extubated and transferred out of the pediatric intensive care unit after 48 hours and discharged after 72 hours. This patient was found to have a urine 9-carboxy-11-nor-Δ-9-tetrahydrocannabinol concentration of 123 ng/mL, suggestive of consumption of a substantial amount of tetrahydrocannabinol. However, samples from the same batch ingested by the patient were tested by both the manufacturer and U.S. Food and Drug Administration and contained only trace amounts of THC.
As CBD oil use continues to rise, health care professionals should have an adequate understanding of current clinical evidence and state and federal legislation to counsel patients on CBD use in a practical and compassionate manner.
报告一例小儿意外大剂量摄入大麻二酚（CBD）油的病例。
CBD 是大麻植物（Cannabis sativa）中 100 多种具有药理活性的化合物之一。它没有精神活性作用，而且在主流和社交媒体上广泛报道了 CBD 油对多种疾病有疗效，这引起了公众对 CBD 油的极大兴趣。这种兴趣导致 CBD 油的消费者可获得性增加。尽管如此，此类销售在联邦一级仍然是非法的。尽管未经食品和药物管理局批准的 CBD 产品的销售继续增加，但纯度、效力、标签和给药装置仍然不一致。这可能会增加不良事件的风险。本报告描述了一例小儿意外 CBD 油摄入过量导致患儿入住儿科重症监护病房的病例。
患儿最初到急诊就诊，当天早些时候在摄入 CBD 油后被发现无反应后迅速被转至急诊室。到达后，他的神志和呼吸驱动力继续恶化，最终被插管。48 小时后他被拔出气管插管并转至儿科重症监护病房外，72 小时后出院。该患儿的尿液中 9-羧基-11-去甲-Δ-9-四氢大麻酚浓度为 123ng/mL，提示摄入了大量的四氢大麻酚。然而，制造商和美国食品和药物管理局对同一批摄入的样本进行了检测，结果仅显示含有痕量 THC。
随着 CBD 油的使用不断增加，医疗保健专业人员应该充分了解当前的临床证据和州及联邦立法，以便以实际和富有同情心的方式为患者提供 CBD 使用方面的咨询。
